Liability Waiver

Liability Waiver
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Format: (000) 000-0000.
E-mail*
Emergency Contact*

First NameLast Name
Relationship To Contact*
Contact's Phone Number*
Format: (000) 000-0000.
I the, the undersigned, being aware of my own health and physical condition, and having knowledge that my participation in any exercise program may be injurious to my health, and voluntarily participating in a physical activity.

Having such knowledge, I hereby acknowledge this release, any representatives of The Run Club and any hosting party from liability for accidental injury or illness which I may incur as a result of participating in the said physical. I hereby assume all risks connected therewith and consent to participate in said programs.

I agree to disclose any physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in said fitness program.

In lieu of signature I will print my name below, acknowledging my consent to this agreement.
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